Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

NM#27 of 49 states

New Mexico Medicaid Spending

New Mexico's Medicaid program paid $2.19B across 8 providers from 2018–2024. 12 providers in New Mexico are flagged on our risk watchlist. The top procedure code is 99509 (Home visit, assistance w/ ADLs) at $424.6M.

Total Spending

$2.19B

Total Claims

26.3M

Top Providers

8

Beneficiaries

18.8M

Top Procedure

99509

$424.6M

Flagged Providers

12

on risk watchlist

Avg Per Provider

$273.8M

across 8 providers

Yearly Spending Trend

Spending by Top Procedures

99509Home visit, assistance w/ ADLs$424.6M
T1019Personal care services, per 15 min$304.5M
99285Emergency dept visit, high/urgent complexity$92.1M
G0463Hospital outpatient clinic visit$85.1M
99284Emergency dept visit, high complexity$80.7M

Top Procedures in New Mexico

CodeTotal Paid
99509

Home visit, assistance w/ ADLs

$424.6M
T1019

Personal care services, per 15 min

$304.5M
99285

Emergency dept visit, high/urgent complexity

$92.1M
G0463

Hospital outpatient clinic visit

$85.1M
99284

Emergency dept visit, high complexity

$80.7M
99213

Office/outpatient visit, est. patient, low-mod complexity

$74.1M
99214

Office/outpatient visit, est. patient, mod-high complexity

$73.8M
99211

Office/outpatient visit, minimal complexity

$72.0M
99212

Office/outpatient visit, low complexity

$51.7M
99283

Emergency dept visit, moderate complexity

$50.4M
G9006

Coordination of long-term care services, per hour

$50.4M
G9001$31.6M
S5125

Attendant care services, per 15 min

$21.7M
74177

CT abdomen and pelvis with contrast

$19.9M
G0378

Hospital observation service, per hour

$17.6M